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Three-Dimensional Fluid-Attenuated Inversion Recovery Magnetic Resonance Imaging in Sudden Sensorineural Hearing Loss: Correlations With Audiologic and Vestibular Testing

Ryu, In Sun*; Yoon, Tae Hyun*; Ahn, Joong Ho*; Kang, Woo Seok; Choi, Byung Se; Lee, Jeong Hyun§; Shim, Myung Joo*

doi: 10.1097/MAO.0b013e31822e969f
Sensorineural Hearing Loss and Tinnitus

Objective: Three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) magnetic resonance imaging (MRI) has recently been applied to the inner ear, but the relationship between 3D-FLAIR findings and audiovestibular function has been unclear in patients with sudden sensorineural hearing loss (SSNHL). We therefore used 3D-FLAIR MRI to investigate vestibular lesions in patients with SSNHL and determined the correlation between these radiologic findings and results of audiovestibular function tests.

Study Design: Prospective study.

Methods: We enrolled 35 patients who presented with SSNHL from 2008 to 2009. Before treatment, all patients underwent audiovestibular evaluation including pure tone audiometry, electronystagmography, subjective visual vertical, subjective visual horizontal, vestibular evoked myogenic potential, and caloric tests. Pathologic conditions of the inner ears were evaluated by 3D-FLAIR at 3 Tesla, with and without gadolinium enhancement.

Results: Of the 35 patients with SSNHL, 12 (34.3%) showed high signals in the affected inner ear on precontrast 3D-FLAIR MRI. Rates of abnormal results on all vestibular function tests were significantly higher for patients with vestibular lesions than those without vestibular lesions on FLAIR (p < 0.05). Vestibular lesions significantly correlated with the presence of vertigo (relative risk, 3.857; 95% confidence interval, 2.039-7.297) and occurrence of vestibular dysfunction (p < 0.05). There was a significant negative correlation between hearing recovery and positive findings on FLAIR (relative risk, −0.475; 95% confidence interval, −0.698 to −0.175; p = 0.004).

Conclusion: High signals in the affected inner ear on 3D-FLAIR MRI closely correlate with vestibular dysfunction and poor hearing recovery in patients with SSNHL, especially when the vestibular apparatus is involved.

*Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul; †Department of Otolaryngology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung; ‡Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam; and §Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Address correspondence and reprint requests to Tae Hyun Yoon, M.D., Ph.D., Asan Medical Center, 388-1 Pungnap-2 Dong, Songpa-Gu, Seoul 138-736, Korea; E-mail:

The authors have no financial disclosure. The authors also declare no conflict of interest.

© 2011 Otology & Neurotology, Inc.